Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-29T11:37:36.128Z Has data issue: false hasContentIssue false
  • English
  • Français

The representation of public values in health technology assessment to inform funding decisions: the case of Australia's national funding bodies

Published online by Cambridge University Press:  18 January 2021

Hossein Haji Ali Afzali Open the ORCID record for Hossein Haji Ali Afzali [Opens in a new window] ,
Jackie Street Open the ORCID record for Jackie Street [Opens in a new window] ,
Tracy Merlin  and
Jonathan Karnon
Hossein Haji Ali Afzali*
Affiliation:
College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042, Australia
Jackie Street
Affiliation:
School of Health and Society, University of Wollongong, Wollongong, New South Wales 2522, Australia
Tracy Merlin
Affiliation:
School of Public Health, The University of Adelaide, Adelaide, South Australia 5005, Australia
Jonathan Karnon
Affiliation:
College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042, Australia
*
Author for correspondence: Hossein Haji Ali Afzali, E-mail: hossein.afzali@flinders.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Over the past few years, there has been an increasing recognition of the value of public involvement in health technology assessment (HTA) to ensure the legitimacy and fairness of public funding decisions [Street J, Stafinski T, Lopes E, Menon D. Defining the role of the public in Health Technology Assessment (HTA) and HTA-informed decision-making processes. Int J Technol Assess Health Care. 2020;36:87–95]. However, important challenges remain, in particular, how to reorient HTA to reflect public priorities. In a recent international survey of thirty HTA agencies conducted by the International Network of Agencies for HTA (INAHTA), public engagement in HTA was listed as one of the “Top 10” challenges for HTA agencies [O'Rourke B, Werko SS, Merlin T, Huang LY, Schuller T. The “Top 10” challenges for health technology assessment: INAHTA viewpoint. Int J Technol Assess. 2020;36:1–4].

Historically, Australia has been at the forefront of the application of HTA for assessing the effectiveness and cost-effectiveness of new health technologies to inform public funding decisions. However, current HTA processes in Australia lack meaningful public inputs. Using Australia as an example, we describe this important limitation and discuss the potential impact of this gap on the health system and future directions.

Keywords

Health technology assessmentPublic valuesDecision makingAustralia
Type
Perspective
Information
International Journal of Technology Assessment in Health Care , Volume 37 , Issue 1 , 2021 , e22
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hailey, D. The history of health technology assessment in Australia. Int J Technol Assess Health Care. 2009;25:61–7.CrossRefGoogle ScholarPubMed
Australian Institute of Health and Welfare (AIHW). Health expenditure Australia 2017–18. Canberra: AIHW; 2019.Google Scholar
Dakin, H, Devlin, N, Feng, Y, Rice, N, O'Neill, P, Parkin, D. The influence of cost-effectiveness and other factors on NICE decisions. London: Office of Health Economics; 2013 [accessed June 2020]. Available from: https://www.ohe.org/publications/influence-cost-effectiveness-and-other-factors-nice-decisions#CrossRefGoogle Scholar
Edney, LC, Haji Ali Afzali, H, Cheng, TC, Karnon, J. Estimating the reference incremental cost-effectiveness ratio for the Australian health system. Pharmacoeconomics. 2018;36:239–52.CrossRefGoogle ScholarPubMed
Carter, D, Vogan, A, Haji Ali Afzali, H. Governments need better guidance to maximise value for money: The case of Australia's Pharmaceutical Benefits Advisory Committee. Appl Health Econ Health Policy. 2016;14:401–7.CrossRefGoogle ScholarPubMed
Wang, S, Gum, D, Merlin, T. Comparing the ICERs in medicine reimbursement submissions to NICE and PBAC: Does the presence of an explicit threshold affect the ICER proposed? Value Health. 2018;21:938–43.CrossRefGoogle Scholar
Edney, L, Haji Ali Afzali, H, Karnon, J. Are the benefits of new health services greater than their opportunity costs? Aust Health Rev. 2019;43:508–10.Google ScholarPubMed
Medical Services Advisory Committee. Technical guidelines for preparing assessment reports for the Medical Services Advisory Committee: Therapeutic (Version 2.0). Canberra: Australin Government; 2016.Google Scholar
Pharmaceutical Benefits Advisory Committee. Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee (Version 5.0). Canberra: Australian Government; 2016.Google Scholar
Australian Governemnet. HTA Consumer Consultative Committee. [accessed Oct 2020]. Available from: https://www1.health.gov.au/internet/hta/publishing.nsf/Content/cccGoogle Scholar
Australian Governemnet. Consumer evidence and engagemnet unit. [accessed Nov 2020]. Available from: https://www1.health.gov.au/internet/hta/publishing.nsf/Content/consumersGoogle Scholar
Street, J, Stafinski, T, Lopes, E, Menon, D. Defining the role of the public in Health Technology Assessment (HTA) and HTA-informed decision-making processes. Int J Technol Assess Health Care. 2020;36:87–95.CrossRefGoogle ScholarPubMed
Menon, D, Stafinski, T. Role of patient and public participation in health technology assessment and coverage decisions. Expert Rev Pharmacoecon Outcomes Res. 2011;11:75–89.CrossRefGoogle ScholarPubMed
Richardson, J, Schlander, M. Health technology assessment (HTA) and economic evaluation: Efficiency or fairness first. J Mark Access Health Policy. 2019;7:1557981.CrossRefGoogle ScholarPubMed
McKie, J, Richardson, J. Social preferences for prioritizing the treatment of severely ill patients: The relevance of severity, expected benefit, past health and lifetime health. Health Policy. 2017;121:913–22.CrossRefGoogle ScholarPubMed
Marseille, E, Kahn, JG. Utilitarianism and the ethical foundations of cost-effectiveness analysis in resource allocation for global health. Philos Ethics Hum Med. 2019;14:5.CrossRefGoogle ScholarPubMed
Wortley, S, Tong, A, Howard, K. Community views and perspectives on public engagement in health technology assessment decision making. Aust Health Rev. 2017;41:68–74.CrossRefGoogle ScholarPubMed
Whitty, JA, Littlejohns, P. Social values and health priority setting in Australia: An analysis applied to the context of health technology assessment. Health Policy. 2015;119:127–36.CrossRefGoogle ScholarPubMed
Dolan, P, Shaw, R, Tsuchiya, A, Williams, A. QALY maximisation and people's preferences: A methodological review of the literature. Health Econ. 2005;14:197–208.CrossRefGoogle ScholarPubMed
Gu, Y, Lancsar, E, Ghijben, P, Butler, JR, Donaldson, C. Attributes and weights in health care priority setting: A systematic review of what counts and to what extent. Soc Sci Med. 2015;146:41–52.CrossRefGoogle ScholarPubMed
Murphy, NJ. Citizen deliberation in setting health-care priorities. Health Expect. 2005;8:172–81.CrossRefGoogle ScholarPubMed
Hodgetts, K, Hiller, JE, Street, JM, Carter, D, Braunack-Mayer, AJ, Watt, AM, et al. Disinvestment policy and the public funding of assisted reproductive technologies: Outcomes of deliberative engagements with three key stakeholder groups. BMC Health Serv Res. 2014;14:204.CrossRefGoogle ScholarPubMed
The National Institute for Health and Care Excellence (NICE). Social value judgements: Principles for the development of NICE guidance. London: NICE; 2013 [accessed June 2020]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395865/pdf/Bookshelf_NBK395865.pdfGoogle Scholar
Davies, C, Wetherell, M, Barnett, E, Seymour-Smith, S. Opening the box: Evaluating the citizens council of NICE. Milton Keynes: The Open University; 2005 [accessed Oct 2020]. Available from: file:///C:/Users/afza0022/AppData/Local/Temp/Davies_C_Barnett_E_Wetherell_M_and_Seymo.pdfGoogle Scholar
O'Rourke, B, Werko, SS, Merlin, T, Huang, LY, Schuller, T. The “Top 10” challenges for health technology assessment: INAHTA viewpoint. Int J Technol Assess. 2020;36:1–4.CrossRefGoogle ScholarPubMed